Shared Decision Making for Prostate Cancer Screening: a Practice-Based Randomized Controlled Trial

• Men's understanding that prostate cancer screening requires a decision [ Time Frame: baseline, post intervention, post clinical visit ] [ Designated as safety issue: No ]
  
• Men's knowledge about prostate cancer and prostate cancer screening [ Time Frame: baseline, post intervention, post clinical visit ] [ Designated as safety issue: No ]
  
• Men's participation in the decision about prostate cancer screening with their clinician at their preferred level [ Time Frame: baseline, post intervention, post clinical visit ] [ Designated as safety issue: No ]
  

• The presence of a shared decision [ Time Frame: post clinical visit ] [ Designated as safety issue: No ]
  
• men's intent to be screened for prostate cancer [ Time Frame: post clinical visit ] [ Designated as safety issue: No ]
  
• Self reported screening [ Time Frame: post visit ] [ Designated as safety issue: No ]
  
• Actual screening by chart review [ Time Frame: 9 month follow-up ] [ Designated as safety issue: No ]
  

Background: Professional societies recommend shared decision making for prostate cancer screening, however, most effort has been directed at informed rather than shared decision making. In this study, we plan to test the effects of a shared decision making intervention on key components of shared decision making. We secondarily plan to test its effects on the presence of a shared decision, men's intention to be screened, and actual screening rates.

Methods: We plan to conduct two separate randomized controlled trials of shared decision making interventions, one in which the intervention focuses on prostate cancer screening only and one in which the intervention focuses on prostate cancer screening in the context of other men's health issues. Each trial will use the same attention control and identical implementation and measurement strategies to allow combination of data if no differences exist in the effect of the interventions. Trials will include a convenience sample of men with no prior history of prostate cancer who present to their primary care physician for routine care. Men will be randomly assigned to a shared decision making intervention (including a video and coaching session for patients and an education session for providers) or a control group, in which men will receive a video on highway safety. Data on key components of shared decision making and intent for screening will be measured at baseline, after the intervention, and after men's visit with their provider. Additionally, medical charts will be reviewed 9 months later to assess for actual screening.